网络出版日期: 2021-05-27
基金资助
上海市卫生和计划生育委员会科研课题(201840083);上海市卫生和计划生育委员会重要薄弱学科建设计划(2015ZB0503);上海市高校产学研课题(RC20190079)
Clinical features of 119 old patients with respiratory virus infection
Online published: 2021-05-27
Supported by
Scientific Research Project of Shanghai Municipal Commission of Health and Family Planning(201840083);Important Weak Discipline Construction Program of Shanghai Municipal Commission of Health and Family Planning(2015ZB0503);Shanghai Universities Research Project of Production, Education and Research(RC20190079)
目的·分析老年呼吸道病毒感染病例的临床特征以及影响临床结局的可能因素。方法·共入组上海交通大学医学院附属瑞金医院老年病科确诊为呼吸道病毒感染的119例住院患者（年龄≥65岁），分析患者的临床症状、实验室检查结果、治疗经过及转归，并比较治愈患者与死亡患者的各项指标。结果·入选患者平均年龄（85.61±7.67）岁，男性98例，女性21例；死亡病例12例。其中，流行性感冒病毒A型感染患者最多（41例）。与治愈患者比较，死亡患者年龄更大，合并细菌感染、胸部CT出现双肺炎症的比例更高（均P<0.05）；在入院时实验室检查中，治愈患者与死亡患者的白细胞、中性粒细胞、红细胞计数，血红蛋白、白蛋白、尿素、肌酐水平，及估算肾小球滤过率比较，差异均有统计学意义（均P<0.05）。结论·年龄偏大，白细胞计数、中性粒细胞计数偏高，血红蛋白、白蛋白水平偏低，肾功能不全，合并有细菌感染可能是老年呼吸道病毒感染患者死亡的影响因素。
黄道 , 韦栋 , 徐志红 , 胡家安 . 老年呼吸道病毒感染119例临床特征分析[J]. 上海交通大学学报（医学版）, 2021 , 41(5) : 628 -631 . DOI: 10.3969/j.issn.1674-8115.2021.05.011
·To analyze the clinical features and risk factors that possibly affect the clinical outcome of elderly patients with respiratory virus infection.
·A total of 119 hospitalized patients (≥65 years old) with respiratory virus infection in the Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were enrolled in this study. The clinical symptoms, laboratory examination, treatment course and outcome were analyzed and compared between cured patients and dead patients.
·The average age of the patients was (85.61±7.67) years old, the male to female ratio was 98∶21 and 12 cases were dead. The number of influenza A virus patients (41 cases) was the most. Compared with cured patients, the dead patients were older, and the proportion of cases with bacterial infection or with double pneumonia in chest CT was higher (P<0.05). In the laboratory examination on admission, there were significant differences between the cured patients and the dead patients on leukocyte count, neutrophil count, erythrocyte count, the levels of hemoglobin, serum albumin, urea, and creatinine, and estimated glomerular filtration rate (P<0.05).
·Older age, higher leukocyte count and neutrophil count, lower hemoglobin and albumin levels, renal insufficiency and bacterial infection may be the influencing factors of death in elderly patients with respiratory virus infection.
Key words： the elderly; respiratory virus infection; clinical features
| 1 | Iuliano AD, Roguski KM, Chang HH, et al. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study[J]. Lancet, 2018, 391(10127): 1285-1300. |
| 2 | van Asten L, van den Wijngaard C, van Pelt W, et al. Mortality attributable to 9 common infections: significant effect of influenza A, respiratory syncytial virus, influenza B, norovirus, and parainfluenza in elderly persons[J]. J Infect Dis, 2012, 206(5): 628-639. |
| 3 | Ruuskanen O, Lahti E, Jennings LC, et al. Viral pneumonia [J]. Lancet, 2011, 377(9773): 1264-1275. |
| 4 | Jain S, Self WH, Wunderink RG, et al. Community-acquired pneumonia requiring hospitalization among U.S. adults [J]. N Engl J Med, 2015, 373(5): 415-427. |
| 5 | Qu JX, Gu L, Pu ZH, et al. Viral etiology of community-acquired pneumonia among adolescents and adults with mild or moderate severity and its relation to age and severity[J]. BMC Infect Dis, 2015, 15: 89. |
| 6 | Gong C, Zhang TG, Luo M, et al. Distribution of the atypical pathogens of community-acquired pneumonia to disease severity[J]. J Thorac Dis, 2018, 10(11): 5991-6001. |
| 7 | Tao RJ, Luo XL, Xu W, et al. Viral infection in community acquired pneumonia patients with fever: a prospective observational study[J]. J Thorac Dis, 2018, 10(7): 4387-4395. |
| 8 | Zhan Y, Yang Z, Chen R, et al. Respiratory virus is a real pathogen in immunocompetent community-acquired pneumonia: comparing to influenza like illness and volunteer controls[J]. BMC Pulm Med, 2014, 14: 144. |
| 9 | Zhou F, Wang Y, Liu Y, et al. Disease severity and clinical outcomes of community-acquired pneumonia caused by non-influenza respiratory viruses in adults: a multicentre prospective registry study from the CAP-China Network [J]. Eur Respir J, 2019, 54(2): 1802406. |
| 10 | Widmer K, Zhu Y, Williams JV, et al. Rates of hospitalizations for respiratory syncytial virus, human metapneumovirus, and influenza virus in older adults[J]. J Infect Dis, 2012, 206(1): 56-62. |
| 11 | Widmer K, Griffin MR, Zhu Y, et al. Respiratory syncytial virus and human metapneumovirus-associated emergency department and hospital burden in adults[J]. Influenza Other Respir Viruses, 2014, 8(3): 347-352. |
| 12 | Ackerson B, Tseng HF, Sy LS, et al. Severe morbidity and mortality associated with respiratory syncytial virus versus influenza infection in hospitalized older adults[J]. Clin Infect Dis, 2019, 69(2): 197-203. |
| 13 | Lee N, Lui GC, Wong KT, et al. High morbidity and mortality in adults hospitalized for respiratory syncytial virus infections[J]. Clin Infect Dis, 2013, 57(8): 1069-1077. |
| 14 | Voiriot G, Visseaux B, Cohen J, et al. Viral-bacterial coinfection affects the presentation and alters the prognosis of severe community-acquired pneumonia[J]. Crit Care, 2016, 20(1): 1-9. |
| 15 | Joseph C, Togawa Y, Shindo N. Bacterial and viral infections associated with influenza[J]. Influenza Other Respir Viruses, 2013, 7(): 105-113. |
| 16 | Yee C, Suarthana E, Dendukuri N, et al. Evaluating the impact of the multiplex respiratory virus panel polymerase chain reaction test on the clinical management of suspected respiratory viral infections in adult patients in a hospital setting[J]. Am J Infect Control, 2016, 44(11): 1396-1398. |
| 17 | Branche AR, Walsh EE, Vargas R, et al. Serum procalcitonin measurement and viral testing to guide antibiotic use for respiratory infections in hospitalized adults: a randomized controlled trial[J]. J Infect Dis, 2015, 212(11): 1692-1700. |
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